Successful management of a fistula between an external iliac artery and an ileal conduit with endovascular embolization and vascular bypass

Abstract

Introduction Fistula formation between an ileac artery and an ileal conduit after radical cystectomy is a rare complication. Case presentation A 72‐year‐old woman underwent laparoscopic radical cystectomy with ileal conduit. After surgery, leakage of ileal‐ureteral anastomosis with infection was observed. Five months after surgery, sudden bleeding from the ileal conduit occurred that stopped spontaneously. Contrast‐enhanced computed tomography suggested a pseudo aneurysm of the right external iliac artery in contact with the ileal conduit. A fistula between the artery and ileal conduit was suspected. She underwent embolization of the common iliac artery and femorofemoral bypass. She had a good clinical course and no sign of hematuria over 6 months of follow‐up. Conclusion An episode of warning hemorrhage from the urostomy is an important sign of fistula, and endovascular treatment is a feasible approach to treat this condition.

Keywords

• aneurysm
• endovascular embolization
• external iliac artery
• fistula
• ileal conduit